竞技高山滑雪运动员的动态膝关节外翻:从青少年到精英的观察结果以及生物成熟度的影响。

Dynamic knee valgus in competitive alpine skiers: Observation from youth to elite and influence of biological maturation.

机构信息

Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

University Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

出版信息

Scand J Med Sci Sports. 2020 Jul;30(7):1212-1220. doi: 10.1111/sms.13657. Epub 2020 Apr 5.

Abstract

Numerous studies investigated the association between dynamic knee valgus and injury risk in post-pubertal and elite athletes; however, normative reference scores for competitive alpine skiers and observations on the development process throughout and beyond athletes' growth spurt are lacking. Thus, the aim of this study was to describe the dynamic knee valgus of competitive alpine skiers during drop jump landings (DJ) and single-leg squats (SLS) with respect to sex, sportive level, and biological maturation. Thirty-seven elite and 104 youth competitive alpine skiers around the growth spurt (U15) were examined for their maximal medial knee displacement (MKD) during DJ and SLS by a marker-based 3D motion analysis evaluating dynamic knee valgus. Additionally, skiers' age, anthropometry and biological maturation were assessed. MKD of youth and elite alpine skiers during DJ was comparable and did not improve with increasing training age. Female U15 skiers (on average further matured) had significantly larger MKD values during DJ than male U15 skiers (less matured) (P < .01). Moreover, MKD during DJ was directly associated with the athlete's individual biological maturation status. MKD values obtained from DJ significantly differed from those obtained during SLS (P < .01). The gender-specific difference in MKD values during DJ and their relationship with maturity offset highlight the fundamental changes to the neuromuscular control system during the growth spurt. Thus, biological maturation needs to be considered as a confounding factor for knee valgus screening. Caution is required when evaluating MKD by using high- and low-dynamic tasks, as corresponding information can differ.

摘要

大量研究调查了动态膝外翻与青春期后和精英运动员受伤风险之间的关系;然而,缺乏竞技高山滑雪运动员的规范参考评分以及对整个生长突增期间和之后的发展过程的观察。因此,本研究的目的是描述竞技高山滑雪运动员在跳下跳落地(DJ)和单腿深蹲(SLS)时的动态膝外翻,具体涉及性别、运动水平和生物成熟度。对 37 名精英和 104 名接近生长突增的青年竞技高山滑雪运动员(U15)进行了基于标记的 3D 运动分析,以评估动态膝外翻,评估他们在 DJ 和 SLS 期间的最大内侧膝位移(MKD)。此外,还评估了滑雪者的年龄、人体测量学和生物成熟度。DJ 期间,青年和精英高山滑雪运动员的 MKD 相似,且随着训练年龄的增加而没有提高。与成熟的男性 U15 滑雪运动员相比(U15 滑雪运动员成熟度较低),U15 女性滑雪运动员(平均进一步成熟)在 DJ 时的 MKD 值明显更大(P <.01)。此外,DJ 期间的 MKD 与运动员的个体生物成熟度状态直接相关。DJ 期间获得的 MKD 值与 SLS 期间获得的 MKD 值显著不同(P <.01)。DJ 期间 MKD 值的性别差异及其与成熟度偏移的关系突出了生长突增期间对神经肌肉控制系统的根本变化。因此,生物成熟度需要作为膝外翻筛查的混杂因素来考虑。在使用高动态和低动态任务评估 MKD 时需要谨慎,因为对应的信息可能会有所不同。

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